Expert Advice

The Legal Issue Around Eye Ointment At Birth

A growing conversation about routine administration of eye ointment to babies at birth is opening the eyes of parents and health care practitioners who question its value. Understanding the legal issue around eye ointment can help you know what birth preferences your birth plan can cover.

In the 1800’s, the bacteria that caused blindness was carried by mothers who had gonorrhea or chlamydia. Silver nitrate eye ointment saved the sight of many newborns in the 1800’s because there was no treatment for these sexually transmitted infections (STI’s) and the opthalmia neonatorum (ON) conjunctivitis (pink eye) they caused. Because of the success, it became routine practice to give eye ointment to all babies at birth.

But today, we have both treatment and regular screening for pregnant women. Most women are screened at least twice during pregnancy and treated for gonorrhea and/or chlamydia, if necessary. Consequently, it’s rare if babies get ON. Even if baby contracts the bacteria during birth, it’s easily treated with antibiotics like erythromycin.

LAWS VARY

In some well-meaning hospitals, current practice doesn’t match current research[1] findings. They continue to routinely give eye ointment to all babies, even the ones whose mothers don’t have STI’s.

Some parents have begun to question the practice, and some object to it. They point to the United Kingdom and Australia, counterparts to the United States, where they’ve abandoned routine administration of eye drops to newborns.

Laws around giving baby eye ointment at birth vary in the United States. Some states allow parents to make the choice whether their baby receives eye ointment, but some do not.

Many US states require eye ointment be given immediately at birth. If parents refuse, the hospital can call Child Protective Services and have baby removed temporarily so the ointment can be administered. This is a serious matter, and some lawyers recommend[2] that if it happens to you, you should immediately call your lawyer.

If your newborn gets eye ointment—and when she gets it—is a choice you can state on your birth plan, if your state law allows. As you research your birth preferences, find out what your state laws are regarding this issue. Even if your state doesn’t give you parental choice, you can still mention your preference in your birth plan.

If your state is one that demands every baby has eye ointment, talk with your care provider and hospital in advance. Maybe it’s possible to plan for waiting at least an hour after the birth so you and baby can bond. Some states will wait as long as three hours.

If it’s possible and you want to wait, you can include that request in the most recent copy of your birth plan, the one listed on your hospital bag checklist. Make sure it goes with you in your hospital bag!

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